S&H Audit 1

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Safety and health audit form

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S&H Audit 1

  1. 1. ASSESSMENT PROFILE SHEET ASSESSMENT DATE: Check One With "X" SUB: SELF PERFORM: OPER. CO.: CONSTRUCTION MGMT (CM) CLIENT NAME: ASSESSOR(S) LABOR POSTURE ACTIVITY Type Name/Location Here OPEN SHOP CONSTRUCTION Type Name/Location Here MERIT SHOP MAINTENANCE Type Name/Location Here UNION Type Name/Location Here OTHER PROJECT INFORMATION PROJECT NAME: PROJECT NUMBER: PROJECT MANAGER: SITE MANAGER: SAFETY MGR/REP: PROJECT LOCATION: CITY: STATE: ZIP: COUNTY PROJECT REGION Check With "X" AMERICAS AFRICA EAST US NLA CANADA ASIA PACIFIC EUROPE WEST US SLA CARIBBEAN AUSTRAILIA MID EAST CENTRAL US CENTRAL AMER. OTHER ASSESSMENT TYPE Check One With "X" GENERAL REQUESTED BY PROJECT CONSULTATION (Non-FD) POST ACCIDENT (Non-Fatal) POST FATALITY FOLLOW-UP (Post Failure) REQUESTED BY CLIENT OTHER INJURY SUMMARY Total LWC's - Project To Date: Total Recordables - Project To Date: Total LWC's - Since Last Audit: Total Recordables - Since Last Audit:
  2. 2. FINAL SCORE SHEET PROJECT NAME: MTH/DAY/YR PROJECT MANAGER: DISTRIBUTION (NAME/LOCATION) DISTRIBUTION (NAME/LOCATION) PROJECT NUMBER: DISTRIBUTION (NAME/LOCATION) DISTRIBUTION (NAME/LOCATION) ASSESSOR(S) IMMINENT DANGER REDUCTION ASSESSMENT SCORE SUMMARY ( IDR ) FINAL SCORE COMPLIANCE 0.00 MAX POSSIBLE ASSESSED TOTAL COMPLIANCE SCORE STANDARD ACHIEVED ADMINISTRATIVE 395.0 0.00 0.00 NO Imminent Danger FIELD EXECUTION 839.0 0.00 0.00 NO A. Instances = 0 15% of Assessed SUBTOTAL 1234.0 0.00 0.00 NO B. Subtotal = 0.00 IDR POINTS (SUBTRACT) 0.00 C. IDR Points ( A x B ) = 0.00 TOTAL 1234.0 0.00 0.00 NO
  3. 3. SAFETY AUDIT DETAILED ASSESSMENT SCORE SUMMARY ADMINISTRATION SCORE SET STANDARD REDUCTION MAXIMUM ASSESSED MINIMUM MET / REPEAT IMMINENT SECTION SECTION NAME POSSIBLE TOTAL STANDARD NOT MET DEFICIENCY DANGER 1 Occupational health & safety policy statement 14.0 0.0 11.2 NOT MET 0 0 2 Safety and medical recordkeeping practices 22.0 0.0 17.6 NOT MET 0 0 3 Emergency preparedness 30.0 0.0 24.0 NOT MET 0 0 4 Infectious diseases 30.0 0.0 24.0 NOT MET 0 0 5 Hazard communication program 46.0 0.0 36.8 NOT MET 0 0 6 Mobil Equipment 28.0 0.0 22.4 NOT MET 0 0 7 Inspection Procedures 26.0 0.0 20.8 NOT MET 0 0 8 Respiratory protection 26.0 0.0 20.8 NOT MET 0 0 9 Enforcement and discipline 10.0 0.0 8.0 NOT MET 0 0 10 Education and training 18.0 0.0 14.4 NOT MET 0 0 11 Performance indicators 17.0 0.0 13.6 NOT MET 0 0 12 Accident / incident investigation 9.0 0.0 7.2 NOT MET 0 0 13 Contractors 22.0 0.0 17.6 NOT MET 0 0 14 Safety Task Assignment (STA) 12.0 0.0 9.6 NOT MET 0 0 15 Regulatory agency inspection / contact 10.0 0.0 8.0 NOT MET 0 0 16 Claims Management 5.0 0.0 4.0 NOT MET 0 0 17 Process Safety Management (PSM) 12.0 0.0 9.6 NOT MET 0 0 18 Substance Abuse Program 6.0 0.0 4.8 NOT MET 0 0 19 Strategic Initiatives 52.0 0.0 41.6 NOT MET 0 0 TOTALS 395.0 0.0 276.5 NOT MET 0 0 shaudit1-1263928624343-phpapp01.xls 3 01/19/2010
  4. 4. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) OCCUPATIONAL HEALTH & 1 SAFETY POLICY STATEMENT A. Policy statement is in writing. 1.0 0.0 0.0% B. Policy statement is dated. 1.0 0.0 0.0% A site specific safety plan has been developed C. and approved / accepted by project 1.0 0.0 0.0% management. D. Health & Safety objectives are clearly stated. 1.0 0.0 0.0% E. Health & Safety responsibilities are defined. 1.0 0.0 0.0% Weekly Safety Committee meetings have been F. established that include the Site Manager, 1.0 0.0 0.0% Supervisors, and Employees All contractors have been given a copy of the G. 2.0 0.0 0.0% Site Specific Safety Plan. Management commitment to safety is stated and H. 1.0 0.0 0.0% communicated to all employees. A current and complete copy of the Corporate I. APS manual is located on site and available to 2.0 0.0 0.0% all members of management and supervision. The project has implemented a safety incentive program for all site employees, including J. 1.0 0.0 0.0% contractors and subcontractors using the Three Tier Approach. * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 4 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  5. 5. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) OCCUPATIONAL HEALTH & 1 SAFETY POLICY STATEMENT (con'td) The projects' safety incentive plans are in writing K. and have been approved by project 1.0 0.0 0.0% management The Pre-job accident prevention planning L. checklist (Corp. APS Manual) has been properly 1.0 0.0 0.0% utilized. M. Other 0.0 0.0 TOTAL 14.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 5 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  6. 6. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) SAFETY AND MEDICAL 2 RECORDKEEPING PRACTICES Injury statistics are tabulated and utilized to A. 1.0 0.0 0.0% identify positive / negative trends. Mandatory regulatory injury and illness record B. keeping. The injury and illness log is available / utilized / 1 2.0 0.0 0.0% accurate. 2 The previous years records are available. 2.0 0.0 0.0% Employees first report of injury, or approved 3 equivalent form, is on file for each recorded 2.0 0.0 0.0% injury or illness. The injury and illness log corresponds with the 4 1.0 0.0 0.0% corporate MAER statistics. Employees Occupational Injury / Illness report C. 2.0 0.0 0.0% form utilized. D. First Aid log utilized / current / accurate. 1.0 0.0 0.0% Required First Aid supplies are available / stored E. 2.0 0.0 0.0% / dispensed in an approved manner. Prescription medications are available / stored / F. 2.0 0.0 0.0% dispensed with approval of medical doctor. Person(s) administering First Aid are trained and G. 2.0 0.0 0.0% certified. * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 6 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  7. 7. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) SAFETY AND MEDICAL 2 RECORDKEEPING PRACTICES (cont'd) Employee exposure and medical records are H. 2.0 0.0 0.0% maintained. Return to work forms, or similar documentation I. with the attending physicians signature, are on 2.0 0.0 0.0% file. J. All medical files are complete and organized. 1.0 0.0 0.0% K. Other TOTAL 22.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 7 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  8. 8. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) 3 EMERGENCY PREPAREDNESS A. The Emergency Plan: 1 Is in writing. 2.0 0.0 0.0% 2 Communicated to all project employees 2.0 0.0 0.0% 3 The plan is site specific. 2.0 0.0 0.0% 4 Incorporates clients emergency procedures. 2.0 0.0 0.0% B. There is a coordinator appointed. 2.0 0.0 0.0% Supervisor First Aid training has been C. 2.0 0.0 0.0% conducted. Required emergency lighting and power are D. 2.0 0.0 0.0% available. Required emergency rescue equipment is E. 2.0 0.0 0.0% available. Emergency response members have been F. 2.0 0.0 0.0% identified and trained. Radios and other communication items are G. 2.0 0.0 0.0% available. Periodic emergency evacuation drills are H. 2.0 0.0 0.0% conducted for all employees. The plan includes a method of accounting for all I. employees after an emergency evacuation 2.0 0.0 0.0% occurs. * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 8 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  9. 9. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) EMERGENCY PREPAREDNESS 3 (con'td) Employees have a working knowledge of J. Emergency / Evacuation Procedures, Escape 2.0 0.0 0.0% Routes and Emergency Notification Process. Emergency evacuation signs or exit signs are K. posted where required and are adequately 2.0 0.0 0.0% visible. Key personnel and contact numbers are L. 2.0 0.0 0.0% reviewed and updated on a monthly basis. M. Other 0.0 0.0 TOTAL 30.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 9 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  10. 10. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) 4 INFECTIOUS DISEASES A written exposure control plan has been A. 2.0 0.0 0.0% established. Employees who have potential to come in B. contact with an infectious disease have been 2.0 0.0 0.0% identified and trained. Hepatitis B vaccination has been offered to C. 2.0 0.0 0.0% those employees having potential exposure. The medical treatment facility is maintained in a D. clean and sanitary condition and a cleaning 2.0 0.0 0.0% schedule has been established. Hand-washing facilities and procedures are E. 2.0 0.0 0.0% established and utilized. Employees exposed to blood or other bodily F. 3.0 0.0 0.0% fluids utilize the P.P.E. required. Surgical gloves, masks, eye / face and G. 3.0 0.0 0.0% protective clothing are available. H. Bag valve masks are readily available. 3.0 0.0 0.0% Sharps or syringes are placed in a labeled I. puncture- resistant, leak-proof container for 3.0 0.0 0.0% disposal as required. Equipment and instruments are immediately J. 3.0 0.0 0.0% disinfected after each use. Contaminated disposable objects or materials (bloody bandages, etc.) are placed in a leak- K. proof, puncture-resistant, red biohazard 3.0 0.0 0.0% container for disposal as required. * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 10 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  11. 11. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) 4 INFECTIOUS DISEASES (cont'd) Training related to infectious diseases safety L. and vaccinations given / refused is adequately 2.0 0.0 0.0% documented. M. Other 0.0 0.0 TOTAL 30.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 11 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  12. 12. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) HAZARD COMMUNICATION 5 PROGRAM A. Written Program: 1 Site specific 2.0 0.0 0.0% 2 There is a designated program administrator. 2.0 0.0 0.0% 3 Identifies labels and warning methods. 2.0 0.0 0.0% Identifies methods of informing employees of 4 2.0 0.0 0.0% non-routine tasks. For multi-employer sites, communication 5 2.0 0.0 0.0% between contractors (Re: Hazcom) 6 Procurement is involved. 2.0 0.0 0.0% B. Record keeping: 1 The inventory list is in place / current / complete. 2.0 0.0 0.0% 2 The MSDS file is in place / current / complete 2.0 0.0 0.0% 3 Records of all Hazcom training on file. 2.0 0.0 0.0% 4 The written Hazcom plan is on file. 2.0 0.0 0.0% Test results on file from Hazcom training 5 2.0 0.0 0.0% sessions. C. Training includes: 1 OSHA requirements /standards on Hazcom. 2.0 0.0 0.0% 2 Fluor Daniel Hazcom program requirements. 2.0 0.0 0.0% 3 Labeling system. 2.0 0.0 0.0% 4 Location of MSDS's 2.0 0.0 0.0% * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 12 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  13. 13. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) HAZARD COMMUNICATION 5 PROGRAM (cont'd) 5 Use of MSDS 2.0 0.0 0.0% 6 Personal Protection Equipment 2.0 0.0 0.0% 7 Non-routine tasks 2.0 0.0 0.0% 8 Refresher / annual up date training 2.0 0.0 0.0% Copies of on site contractor hazcom programs D. 2.0 0.0 0.0% are available. Employees are knowledgeable of the hazcom E. 2.0 0.0 0.0% program based on responses to questions. Vessels and material containers are labeled as F. 2.0 0.0 0.0% required. Hazard information posters / signs are displayed G. 2.0 0.0 0.0% to inform employees. H. Other 0.0 0.0 TOTAL 46.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 13 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  14. 14. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) MOBILE EQUIPMENT 6 OPERATIONS There is a maintenance schedule for all mobile A. 2.0 0.0 0.0% equipment and the schedule is followed. Daily pre-operational inspections are performed B. 2.0 0.0 0.0% on all equipment. Annual inspections are performed on all C 2.0 0.0 0.0% equipment (cranes certified). Mobile equipment accidents are investigated D 1.0 0.0 0.0% and reported. Suspended work baskets are certified as safe E 3.0 0.0 0.0% and utilized for personnel as required. Suspended work baskets are built according to F 3.0 0.0 0.0% approved designs. Suspended work baskets are labeled as required to show maximum weight capacity, G 3.0 0.0 0.0% maximum number of persons allowed and total basket weight (actual empty weight). Permits are utilized and retained for suspended H 3.0 0.0 0.0% work basket usage. Critical lift permits are utilized in accordance with I 3.0 0.0 0.0% corporate policy. A load test has been performed that established J a safety factor of 2 times for the suspended work 3.0 0.0 0.0% basket. Operator certification program is utilized for K 3.0 0.0 0.0% aerial lifts, heavy equipment and vehicles. L Other 0.0 0.0 TOTAL 28.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 14 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  15. 15. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) 7 INSPECTION PROCEDURES Regular safety inspections of the site / operation are conducted by using Bi-weekly Walk Abouts A. 2.0 0.0 0.0% as well as Weekly Safety Self Assessments and documented. Inspection program has been implemented for B. the following: 1 Power tools 2.0 0.0 0.0% 2 Assured grounding and electrical cords / leads 2.0 0.0 0.0% 3 Fire extinguishers 2.0 0.0 0.0% 4 Ladders 2.0 0.0 0.0% 5 Scaffolds 2.0 0.0 0.0% 6 Rigging /Hoisting equipment and devices 2.0 0.0 0.0% 7 Fall protection equipment and devices 2.0 0.0 0.0% 8 Emergency and rescue equipment 2.0 0.0 0.0% 9 Excavations 2.0 0.0 0.0% 10 Temporary electrical distribution installations 2.0 0.0 0.0% 11 Electrical (ARC) welding equipment 2.0 0.0 0.0% There is a follow-up procedure established for C the correction of deficiencies noted during 2.0 0.0 0.0% inspections. D. Other 0.0 0.0 TOTAL 26.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 15 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  16. 16. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) 8 RESPIRATORY PROTECTION There is a written respiratory protection program which addresses the respiratory protection A. 2.0 0.0 0.0% exposure / need as required, or a written respirator use assessment. Fit testing is provided for all employees required B. 2.0 0.0 0.0% to wear respirators (both APR's and SAR's). Employees are offered at least 2 different C. 2.0 0.0 0.0% makes, models and sizes of respirators. Documentation of respirator selection criteria is D. available (i.e. air sample results, calculations, 2.0 0.0 0.0% etc.) Respiratory protection training is conducted, E. 2.0 0.0 0.0% documented, and validated by testing. Records of training, medical assessment and fit F. testing are available, and meet confidentiality 2.0 0.0 0.0% requirement. Seal checks are performed and documented G. 2.0 0.0 0.0% each time respirators are used. Breathing air for supplied air respirators meets H. breathing air requirements. Sample results are 2.0 0.0 0.0% available. If a breathing air compressor is used, it is equipped with a proper filtration system, Co I. 2.0 0.0 0.0% Alarm, reserve air tank and compressor failure alarm. RESPIRATORY PROTECTION 8 (cont'd) Hose couplings used with supplied air J. respirators are incompatible with other 2.0 0.0 0.0% couplings. * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 16 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  17. 17. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) K. Breathing air cylinders are labeled as required. 2.0 0.0 0.0% Respiratory protection equipment is properly L. 2.0 0.0 0.0% cleaned, sanitized, and stored after being used. Periodic inspections are performed and M. documented to ensure that all elements of the 2.0 0.0 0.0% written program are effective. TOTAL 26.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 17 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  18. 18. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) 9 ENFORCEMENT AND DISCIPLINE Employee Health & Safety responsibilities have A. 2.0 0.0 0.0% been communicated to all employees. Supervisor Health & Safety responsibilities have B. 2.0 0.0 0.0% been communicated to all supervisors. Records of employee safety related discipline C. are maintained. (i.e. verbal / written warning, 2.0 0.0 0.0% retraining, termination, etc. ) Disciplinary action is initiated by supervision D. when unsafe acts / conditions / imminent danger 2.0 0.0 0.0% occur. The record of disciplinary action is consistent E. with the record of incidents and accidents where 2.0 0.0 0.0% disciplinary action was warranted. F. Other 0.0 0.0 TOTAL 10.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 18 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  19. 19. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) 10 EDUCATION AND TRAINING New employee orientation is provided for employees by utilizing the Project Safety A. 2.0 0.0 0.0% Enhancement Guide alongwith New Hire Mentor Program. Elective safety training programs are conducted B. for management and supervisors to maintain 2.0 0.0 100.0% their SCCS certification. C. Task specific training is conducted. 2.0 0.0 0.0% Safety meetings are conducted for all D. 2.0 0.0 0.0% employees, supervisors and management. Emergency preparedness and evacuation E. 2.0 0.0 0.0% training is in place. F. Visitor safety induction program is in place. 2.0 0.0 0.0% Training records are maintained in good order G. 2.0 0.0 0.0% for all employee safety training. Testing performed to assure employee H. 2.0 0.0 0.0% understanding of safety training programs. All site Managers, Supervisors, and Engineers I. have been Safety Certifided by completing the 2.0 0.0 100.0% mandatory 3 Core Competency courses. J. Other 0.0 0.0 TOTAL 18.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 19 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  20. 20. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) 11 PERFORMANCE INDICATORS There has not been a fatal injury in the A. 10.0 0.0 0.0% workplace during the past six months. The year-to-date lost time injury frequency rate B. 3.0 0.0 0.0% is zero. The year-to-date recordable incidence rate is at or below the current corporate goal. C. 3.0 0.0 0.0% Actual, ytd _________ Current Goal __________ Contractor / Subcontractor Experience is D. 1.0 0.0 0.0% reported and measured. E. Other 0.0 0.0 TOTAL 17.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 20 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  21. 21. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) ACCIDENT / INCIDENT 12 INVESTIGATION A. There is a written accident / incident policy. 1.0 0.0 0.0% Accident / incident policy complies with local B. 2.0 0.0 0.0% regulatory reporting requirements. C. A standard investigation format is used. 1.0 0.0 0.0% Serious injury and fatal injury accidents are D. communicated to management personnel, 1.0 0.0 0.0% expeditiously as required. All lost time injury reports are reviewed by site E. 1.0 0.0 0.0% management. There is a remedial follow-up and action plan to F. 2.0 0.0 0.0% prevent recurrent of accidents / incidents. Accident / incidents information is shared with G. 1.0 0.0 0.0% other operations / projects. H. Other 0.0 0.0 TOTAL 9.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 21 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  22. 22. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) 13 CONTRACTORS Written qualifications are established for the A. 2.0 0.0 0.0% selection of contractors. Past Health & Safety performance is factored B. 2.0 0.0 0.0% into contractor selection. Contractors are required to provide a copy of C. 1.0 0.0 0.0% their safety program. Prior to starting work on-site, contractors are D. 2.0 0.0 0.0% provided site orientation. Prior to starting work on-site, contractors are E. provided the operations health and safety rules, 2.0 0.0 0.0% and emergency procedures. Prior to starting work on-site, contractors are F. made aware of any chemicals they may 2.0 0.0 0.0% encounter on-site. Prior to bringing any chemicals on-site, contractors are required to inform safety of the G. 2.0 0.0 0.0% chemicals and provide a material safety data sheet (MSDS). Contractors are required to follow the same H. health and safety rules as Fluor Daniel 2.0 0.0 0.0% employees. I. Safety violations are properly documented. 2.0 0.0 0.0% * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 22 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  23. 23. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) 13 CONTRACTORS (cont'd) Corrective action taken by subcontractors to J. 2.0 0.0 0.0% correct violation and is properly documented Contractors are required to utilize the FD STA K. 3.0 0.0 0.0% process (or equivalent program). L. Other 0.0 0.0 TOTAL 22.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 23 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  24. 24. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) SAFETY TASK ASSIGNMENT 14 (STA) A. Employees are given STA by their supervisors 3.0 0.0 0.0% The Safety Task Assignment form S20 or B. 3.0 0.0 0.0% equivalent is being used. Employees questioned about the STA process C. 3.0 0.0 0.0% where knowledgeable of the requirement. Evidence of STA planning / instruction is visible D. 3.0 0.0 0.0% in the field. E. Other 0.0 0.0 TOTAL 12.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 24 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  25. 25. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) REGULATORY AGENCY 15 INSPECTION / CONTACT Two members of management have been identified as project representatives to A. 1.0 0.0 0.0% participate in regulatory agency visits / inspections. The management members selected to B. represent the project during regulatory agency visits have been trained in the following topics. 1 Opening Conference 1.0 0.0 0.0% 2 Walk around /inspection phase 1.0 0.0 0.0% 3 Records /note taking 1.0 0.0 0.0% 4 Tests 1.0 0.0 0.0% 5 Photographs 1.0 0.0 0.0% 6 Employee interview procedures 1.0 0.0 0.0% 7 Closing conference 1.0 0.0 0.0% 8 Post inspection report 1.0 0.0 0.0% 9 Corporate notification 1.0 0.0 0.0% C. Other 0.0 0.0 TOTAL 10.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 25 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  26. 26. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) 16 CLAIMS MANAGEMENT A. Project has established Company physicians. 1.0 0.0 0.0% Employees' First Report of Injury filed with B. 1.0 0.0 0.0% insurance carrier within 24 hours. Employees have been notified in writing of their C. responsibility to report a Workers' Compensation 1.0 0.0 0.0% claim. Modified Work / Restricted Work program D. 1.0 0.0 0.0% established and implemented at Project. Project Management is pro-Active in Post Injury E. follow up and to express their concern for the 1.0 0.0 0.0% injured employee (Case Management). F. Other 0.0 0.0 TOTAL 5.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 26 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  27. 27. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) PROCESS SAFETY 17 MANAGEMENT (PSM) Known fire, explosion, and toxic release hazards have been communicated to employees who are A. 3.0 0.0 0.0% working on or around covered equipment or processes. Applicable provisions of the plant emergency B. action and evacuation plan has been 3.0 0.0 0.0% communicated to all affected employees. Site safe work practices have been C. 3.0 0.0 0.0% communicated to all affected employees. Affected employees have been trained in all of the above listed procedures and practices. D. Testing procedures to ensure employee 3.0 0.0 0.0% competency and understanding have been established. E. Other 0.0 0.0 TOTAL 12.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 27 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  28. 28. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) 18 SUBSTANCE ABUSE PROGRAM The project has an approved Substance Abuse A. Prevention Policy and Project Specific 1.0 0.0 0.0% Procedures. The project conducts post-offer / pre-placement B. 1.0 0.0 0.0% testing for all new / rehire employees. C. The project conducts random screening. 1.0 0.0 0.0% The project conducts post accident and for D. 1.0 0.0 0.0% cause testing. All contractors / subcontractors are required to E. adhere to the Corporate substance abuse 1.0 0.0 0.0% prevention program. F. The project includes testing for alcohol. 1.0 0.0 0.0% G. Other 0.0 0.0 TOTAL 6.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 28 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  29. 29. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) 19 STRATEGIC INITIATIVES A. The strategies 2000 manual is available on site. 4.0 0.0 0.0% Section 1 - Contractor prequalification evaluation B. 4.0 0.0 0.0% process has been implemented as required. Section 2. - Accountability programs have been C. 4.0 0.0 0.0% implemented as required. Section 3 - Pre-bid, pre-mobilization alignments D. for subcontractors has been implemented and 4.0 0.0 0.0% required. Section 4 - Safety resources for subcontractors E. 4.0 0.0 0.0% has been implemented as required. Section 5 - Safety orientation guidelines for F. subcontractors has been implemented as 4.0 0.0 0.0% required. Section 6 - Safety Task Assignment (STA) for G. subcontractors has been implemented as 4.0 0.0 0.0% required. Section 7 - Scaffold guidelines for subcontractor H. 4.0 0.0 0.0% has been implemented as required. Section 8 - Fall hazard management for I. subcontractors has been implemented as 4.0 0.0 0.0% required. Section 9 - Remote travel and driver safety J. guidelines for subcontractors has been 4.0 0.0 0.0% implemented as required. * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 29 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  30. 30. SAFETY AUDIT ADMINISTRATION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES DANGER POSSIBLE ASSESSED 0 - 100 ASSESSORS COMMENTS (X) (X) 19 STRATEGIC INITIATIVES (cont'd) Section 10 - heavy haulage vehicle safety for K. subcontractors has been implemented as 4.0 0.0 0.0% required. Section 11 - Safety training has been L. 4.0 0.0 0.0% implemented as required. Section 12 - Corporate management ownership M. for subcontractors has been implemented as 4.0 0.0 0.0% required. TOTAL 52.0 0.0 0.0% 0 0 * REPEATED DEFICIENCIES = -10 MAX POSSIBLE 8/27/99 30 ** IMMINENT DANGER = 15% REDUCTION OF THE ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  31. 31. SAFETY AUDIT DETAILED ASSESSMENT SCORE SUMMARY FIELD EXECUTION SCORE SET STANDARD REDUCTION MAXIMUM ASSESSED MINIMUM MET / REPEAT IMMINENT SECTION SECTION NAME POSSIBLE TOTAL STANDARD NOT MET DEFICIENCY DANGER 1 Housekeeping 19.0 0.0 15.2 NOT MET 0 0 2 Health & Hygiene 26.0 0.0 20.8 NOT MET 0 0 3 Work Area Lighting 9.0 0.0 7.2 NOT MET 0 0 4 Personal Protective Equipment (P.P.E.) 67.0 0.0 53.6 NOT MET 0 0 5 Hand Tools 13.0 0.0 10.4 NOT MET 0 0 6 Powder Actuated Tools 17.0 0.0 13.6 NOT MET 0 0 7 Power Tools and Power Equipment 19.0 0.0 15.2 NOT MET 0 0 8 Hot Work (Welding, Heating, Burning) 63.0 0.0 50.4 NOT MET 0 0 9 Electrical 59.0 0.0 47.2 NOT MET 0 0 10 Equipment Operations 149.0 0.0 119.2 NOT MET 0 0 11 Excavation and Trenching 30.0 0.0 24 NOT MET 0 0 12 Steel Erection and Floor and Wall Opening 52.0 0.0 41.6 NOT MET 0 0 13 Material Handling Storage 22.0 0.0 17.6 NOT MET 0 0 14 Signs, Signals, Barricades 22.0 0.0 17.6 NOT MET 0 0 15 Fire Prevention and Protection 42.0 0.0 33.6 NOT MET 0 0 Ladders, Scaffolds, and Elevated Work 16 112.0 0.0 89.6 NOT MET 0 0 Platforms Concrete, Concrete Forms, Shoring, 17 22.0 0.0 17.6 NOT MET 0 0 Masonry 18 Demolition 15.0 0.0 12 NOT MET 0 0 19 Blasting - Use of Explosives 19.0 0.0 15.2 NOT MET 0 0 20 High-Pressure Water Cleaning 40.0 0.0 32 NOT MET 0 0 21 Confined Spaces 22.0 0.0 17.6 NOT MET 0 0 TOTALS 839.0 0.0 671.2 NOT MET 0 0 shaudit1-1263928624343-phpapp01.xls 31 01/19/2010
  32. 32. SAFETY AUDIT FIELD EXECUTION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES POSSIBLE ASSESSED 0 - 100 DANGER ASSESSORS COMMENTS (X) (X) 1 HOUSEKEEPING Work areas are clean and free of excess trash / A. debris. 3.0 0.0 0.0% Provisions have been made for routing trash B. collection and disposal. 1.0 0.0 0.0% Trash receptacles are provided in all work areas, C. and one is present at each water keg. 1.0 0.0 0.0% Scrap lumber is free of protruding nails or other D. puncture hazards. 2.0 0.0 0.0% Glass containers are prohibited, none were E. observed. 2.0 0.0 0.0% Electrical cords, hoses, welding leads, etc., are F. elevated to prevent tripping hazards. 3.0 0.0 0.0% Butt cans, where used, are maintained free of G. combustible material and emptied routinely. 1.0 0.0 0.0% Elevated areas are maintained clear of debris, H. material, tools, etc., where such items could fall 3.0 0.0 0.0% to areas below. Drip pans are utilized for oil dispensing locations I. and under threading machines and saws where 3.0 0.0 0.0% lubricant could drip J. Other 0.0 0.0 TOTAL 19.0 0.0 0.0% 0 0 * REPEATED DEFICIENCY = -10 MAX POSSIBLE 01/19/2010 32 ** IMMINENT DANGER = 15% REDUCTION OF ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  33. 33. SAFETY AUDIT FIELD EXECUTION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES POSSIBLE ASSESSED 0 - 100 DANGER ASSESSORS COMMENTS (X) (X) 2 HEALTH & HYGIENE The required number of toilets are provided (1 A. toilet for every 29 workers). 2.0 0.0 0.0% Provisions for servicing / cleaning toilets has B. been made. 2.0 0.0 0.0% Toilets are kept clean and sanitary. Toilet paper C. is in place. 2.0 0.0 0.0% Washing facilities are available for worker use D. prior to lunch / breaks when required. 2.0 0.0 0.0% Vermin (rodents, insects, etc.) control is E. provided. 2.0 0.0 0.0% Ventilation in work areas is provided for the type F. of work being performed. 2.0 0.0 0.0% Local exhaust ventilation is used where G. necessary. 2.0 0.0 0.0% There are designated areas where employees can eat lunch / dinner in a sanitary environment H. separate from any toilet facility and not exposed 2.0 0.0 0.0% to toxic materials. Lunch / dinner areas / facilities are clean and I. kept clean on a regular basis. 2.0 0.0 0.0% A common drinking cup is not allowed, individual J. cups are provided. 2.0 0.0 0.0% The required supply of drinking water is provided K. and conveniently located. 2.0 0.0 0.0% Where water kegs are used they are clean, L. labeled, as required and used only for drinking. 2.0 0.0 0.0% * REPEATED DEFICIENCY = -10 MAX POSSIBLE 01/19/2010 33 ** IMMINENT DANGER = 15% REDUCTION OF ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  34. 34. SAFETY AUDIT FIELD EXECUTION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES POSSIBLE ASSESSED 0 - 100 DANGER ASSESSORS COMMENTS (X) (X) 2 HEALTH & HYGIENE (cont'd) Water kegs are sealed to prevent / indicate M. tamerping 2.0 0.0 0.0% N. Other 0.0 0.0 TOTAL 26.0 0.0 0.0% 0 0 * REPEATED DEFICIENCY = -10 MAX POSSIBLE 01/19/2010 34 ** IMMINENT DANGER = 15% REDUCTION OF ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  35. 35. SAFETY AUDIT FIELD EXECUTION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES POSSIBLE ASSESSED 0 - 100 DANGER ASSESSORS COMMENTS (X) (X) 3 WORK AREA LIGHTING Required lighting is provided for the work being A. performed. 3.0 0.0 0.0% Portable light plants are maintained and kept B. operational. 1.0 0.0 0.0% Portable light plants are positioned to provide C. maximum lighting where required. 1.0 0.0 0.0% Portable light plants are easily moved and D. positioned. 1.0 0.0 0.0% Portable light plant masts are easily raised and E. lowered. 3.0 0.0 0.0% F. Other 0.0 0.0 TOTAL 9.0 0.0 0.0% 0 0 * REPEATED DEFICIENCY = -10 MAX POSSIBLE 01/19/2010 35 ** IMMINENT DANGER = 15% REDUCTION OF ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls
  36. 36. SAFETY AUDIT FIELD EXECUTION SCORE PENALTY * REPEATED ** IMMINENT MAXIMUM % DEFICIENCIES POSSIBLE ASSESSED 0 - 100 DANGER ASSESSORS COMMENTS (X) (X) PERSONAL PROTECTIVE 4 EQUIPMENT (P.P.E.) A. Head Protection 1 Worn where required. 3.0 0.0 0.0% 2 Hard Hat is labeled as site requires 1.0 0.0 0.0% Hard Hat suspension systems maintained in a 3 safe manner. 2.0 0.0 0.0% Hard hats are free from cracks, holes or any 4 damage 2.0 0.0 0.0% B. Eye Protection 1 Worn where required. 2.0 0.0 0.0% 2 Side shields required and used. 2.0 0.0 0.0% 3 Lens cleaning stations and material are provided. 1.0 0.0 0.0% 4 Face shields are worn when required. 2.0 0.0 0.0% Signs are posted at bench grinders "Face shields 5 required." 1.0 0.0 0.0% Safety glasses or goggles are worn under face 6 shields or welding shields. 2.0 0.0 0.0% C. Fall Protection Safety harness is required and used where fall 1 exposure > 2 meters is present. (6ft) 4.0 0.0 0.0% 2 Lanyard are equipped with shock absorbers. 3.0 0.0 0.0% * REPEATED DEFICIENCY = -10 MAX POSSIBLE 01/19/2010 36 ** IMMINENT DANGER = 15% REDUCTION OF ASSESSMENT SCORE shaudit1-1263928624343-phpapp01.xls

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